If you have ADHD, you might be the last to know. And when you finally get diagnosed, you might be surprised to find that no one else is surprised.

Head in SandIt’s common for people with ADHD to underestimate, or even completely fail to recognize, their symptoms.

There’s a whole subfield of ADHD research on this. Most recently, for example, a study of 107 teens with ADHD found that 66 percent of them underreported their symptoms and 24 percent denied they had any symptoms at all! (Their parents, meanwhile, gave higher and more accurate estimates.)

As people with ADHD get older, they do tend to become more self-aware. Still, no one with ADHD is necessarily immune from failing to see the full extent of their symptoms. In psychology generally, it’s widely recognized that people with a whole range of disorders often lack insight into their conditions. This can happen with ADHD too. Here are some of the reasons why:

Getting used to your symptoms: Fish, meet water. When you’re totally immersed in something all day every day, it can be hard to recognize that thing even exists. For people with ADHD, their symptoms are a basic and ongoing fact of life. When you don’t know anything different, it can be hard to see your symptoms as something out of the ordinary.
Not knowing what’s “normal”: It’s easy to assume that other people are like you. It won’t necessarily occur to you that in some regards, the way you go through life is different than the way most other people go through life. So if you want to gain more insight into your symptoms, here’s a little exercise you can do: make a game of observing how other people pay attention, exercise self-control, etc. and see if you notice any discrepancies.
Blaming external factors: When things go wrong, it’s natural to look for external causes you can blame. It’s not fun to find the common denominator in your failures when the way your brain works is that common denominator. So when your ADHD symptoms create chaos in your life, your first instinct might be to chalk your problems up to bad luck or whatever other explanation you can find. But recognizing your ADHD symptoms as a consistent source of problems in your life doesn’t mean you are bad, incompetent, flawed, etc., and acknowledging this distinction can make it easier to take an honest look at how your symptoms are affecting your life. Of course, people with ADHD can also have the opposite problem, too, by blaming all their problems on themselves – the goal is to be able to assess the impact your ADHD symptoms have on your life without making it too personal and spiraling into self-blame.
For people with ADHD, underestimating their symptoms can be a real barrier to diagnosis and treatment. It’s hard to get help for a problem you don’t recognize you have! And even once you do get help, not being aware of your symptoms can stop you from getting the most effective treatment and developing coping strategies that could improve your life.

That’s why if you have ADHD, you owe it to yourself to (1) meet with a therapist and (2) reflect critically on your symptoms and how they could be affecting your life in ways you haven’t yet acknowledged. Doing both these things can help you develop perspective on what ADHD looks like in your everyday life, which makes it easier to take steps that make your life better.

Researchers have successfully adapted a parent-training program for ADHD for use with families in Japan, where ADHD-specific behavioral interventions are limited.

OIST researchers have successfully adapted a parent-training program for ADHD for use with families in Japan, where ADHD-specific behavioral interventions are limited.

The results of the proof-of-concept of the new program, the “New Forest Parenting Programme-Japan,” published in Japanese Psychological Research, show reductions in children’s ADHD symptoms and improvements in parent-child relationships, suggesting that the parent-training program might prove to be an effective mainstream behavioral treatment for ADHD in Japan.

International guidelines for the management of ADHD in children recommend approved medications and/or behavioral therapy. Compared with many western countries, Japan has fewer pharmacological and behavioral options. The availability of behavioral therapy is further limited by a shortage of trained specialists.

Researchers at the Okinawa Institute of Science and Technology Graduate University (OIST) first recruited Japanese parents of children with ADHD for a pilot study using standard behavioral strategies to see if Japanese parents would be comfortable with the program content, assessment strategies and group delivery of the program. Though the researchers did not specify the gender of the parents, only mothers contacted the researchers to participate in the study and five mothers were recruited for the study. The mothers embraced the group setting, expressing the importance of interacting with other mothers who could understand the challenges of parenting a child with ADHD. However, they articulated a desire to have more information about the causes of ADHD as well as extra practice using behavioral strategies specifically targeting ADHD. In response, the OIST researchers adapted the New Forest Parenting Programme, with the support of the program originators, for use with Japanese parents.

“It is important that children with ADHD are rewarded with positive praise after engaging in appropriate behaviors,” says Dr. Shizuka Shimabukuro from OIST’s Human Development Neurobiology Unit, who is the driving force behind adapting the NFPP for Japanese families. “In general, Japanese parents praise their children more sparingly than Western parents. Overcoming this cultural norm can be challenging for many mothers.”

Based on the feedback from the pilot study, researchers in OIST’s Human Development Neurobiology Unit recruited mothers only for the proof-of-concept study. They modified the programme to replace four general parenting strategy sessions with six sessions that were specifically designed for parents of children with ADHD and also added five extra support sessions to the beginning of the training program to increase mothers’ understanding of ADHD and increase their confidence in participating in the parenting program.

The researchers then conducted a proof-of-concept study with the new extended program, known as the NFPP-Japan, with 17 Japanese mothers, to assess the effects of the program on child behavior, mothers’ well-being and parenting skills.

Mothers’ reports before and after the program indicated significant reductions in children’s ADHD symptoms, reductions in mothers’ reactivity to their child’s behavioral difficulties and reductions in the stress they experienced in their roles as parents.

“Because the results of the study are based on self-reports from the mothers, we cannot rule out that the positive results we saw are due to changes in mothers’ perceptions of, or attitudes toward, their child’s behavior,” says Professor Gail Tripp, head of OIST’s Human Development Neurobiology Unit. “Nevertheless, improving the parent-child relationship is an important step in managing ADHD.”

Future studies of the NFPP-Japan will focus on using objective evaluations of child behavior and the parent child-relationship. A randomized control trial of the NFPP-Japan is currently underway. If the program proves successful, it might eventually become generally available in Japan as an effective treatment for managing symptoms of ADHD.

As more people with autism and ADHD begin to advocate for themselves at work, some employers are changing their workplaces.

For employees diagnosed with ADHD or autism, the widespread adoption of open floor plans in the workplace has made it more difficult for them to focus on their work, Matsis-McCready says. Employees with ADHD or autism might need to work in a quiet area with fewer distractions, she says, but their colleagues shouldn’t assume they don’t want to be part of a team or work collaboratively. There are other ways to accommodate an employee with ADHD, Matsis-McCready says, including providing noise-canceling headphones or allowing them to work a flexible schedule that is outside normal business hours, where they come into work a few hours earlier or later than other employees so they have quiet time to complete their work without distractions.

Burns says accommodations for an employee diagnosed with autism include:

Being specific, clear, and concise with directions.

Anticipating a lack of emotional response and not interpreting it to mean that person isn’t engaged in their work or with the team.

Limiting your team’s use of sarcasm and hyperbole.

Looking for opportunities for team building outside the office besides happy hour and team sports.

SAP and Ernst & Young have found that hiring employees with autism bring benefits. They provide a different perspective to problem solving and the creative process, Velasco says. Working with an employee diagnosed with autism can help you become a more effective communicator and manager, says Jamell Mitchell, an associate director at Ernst & Young who manages Briefer and several other employees with autism. “I have found myself pausing and saying, ‘I’m not as clear as I can be,'” he says, “and then taking the time to recraft a communication so it’s clear and I am hitting the key points.”

Attention-deficit/hyperactivity disorder (ADHD) is associated with the delayed development of five brain regions and should be considered a brain disorder, according to a study published in The Lancet Psychiatry.

For the international study, Martine Hoogman, PhD, of the Radboud University Medical Center in Nijmegen, Netherlands, and colleagues included 1713 individuals with ADHD and 1529 without the disorder. Participants were between the ages of 4 and 63.

Magnetic resonance imaging revealed that five brain regions in those with ADHD were smaller than in those without ADHD: the caudate nucleus, putamen, nucleus accumbens, amygdala, and hippocampus. These differences were more prominent in children with ADHD than in adults with the disorder.

“The results from our study confirm that people with ADHD have differences in their brain structure, and therefore suggest that ADHD is a disorder of the brain,” Hoogman said in a journal news release.

The largest imaging study of its kind finds that people diagnosed with ADHD have altered brains. It identifies size differences in several brain regions and the brain overall, with the greatest differences seen in children rather than adults. The researchers say that the findings – from brain images of more than 3,200 people – provide strong evidence that ADHD is a disorder of the brain.

The study – which was funded by the National Institutes of Health (NIH) – is published in The Lancet Psychiatry. It is the work of the ENIGMA Consortium, an international multidisciplinary group that is investigating genetic and brain-imaging differences in psychiatric disorders.

The disorder affects more than 1 in 20 young people under the age of 18. Two thirds of children diagnosed with ADHD continue to experience persistent and impairing symptoms as adults, note the study authors.

Dr. Martine Hoogman, of the department of human genetics at Radboud University Medical Center in Nijmegen, the Netherlands, is principal investigator of the ADHD section of ENIGMA and lead author of the new paper.

She says that the “unprecedented size” of their study is crucial because it helped to identify the “very small – in the range of a few percent” differences in brain region sizes.

“Similar differences in brain volume are also seen in other psychiatric disorders, especially major depressive disorder,” adds Dr. Hoogman.

ADHD brains smaller overall and in certain regions

Previous studies have found links between differences in brain volume and ADHD, but they were limited by small sample sizes, making it difficult to draw any firm conclusions.

Nevertheless, these did point to a number of brain differences in ADHD. For example, some suggested that the basal ganglia – an area of the brain that controls emotion, cognition, and voluntary movement – is involved. They found that two regions in the ganglia, the caudate and putamen, tend to be smaller in people with ADHD.

For the new study, Dr. Hoogman and colleagues measured differences in brain structure from MRI scans of 1,713 participants diagnosed with ADHD, and in 1,529 other people (the controls) who did not have ADHD. The participants’ ages ranged from 4 to 63 years.

From the MRI scans, the team could assess overall brain volume as well as the size of seven regions of the brain that previous studies have linked to ADHD. These were the caudate nucleus, putamen, nucleus accumbens, pallidum, thalamus, amygdala, and hippocampus.

The results showed that the brains of participants with ADHD were smaller overall, and that volumes of five of the seven regions were also smaller: the caudate nucleus, putamen, nucleus accumbens, amygdala, and hippocampus.

The researchers also took into account whether the participants were taking, or had ever taken, medication to treat ADHD (such as Ritalin), but this appeared to have no effect on the findings.

‘Brain disorder characterized by delayed development’

The researchers speculate that the amygdala is linked to ADHD through the part it plays in controlling emotion, and the nucleus accumbens through the role it plays in reward processing. The link between ADHD and the hippocampus could perhaps arise from that region’s involvement in motivation and emotion, they suggest.

The differences in brain size were particularly prominent in the children and less obvious in the adults with ADHD, note the authors, who suggest that their findings show that ADHD is a brain disorder characterized by delayed development in several brain regions.

Despite the large numbers of participants of all ages, the study was not designed to investigate how ADHD might develop over a person’s lifetime. The team says that there is now a need for longitudinal studies that follow children with ADHD into adulthood and track brain changes over time.

“The results from our study confirm that people with ADHD have differences in their brain structure and therefore suggest that ADHD is a disorder of the brain. We hope that this will help to reduce stigma that ADHD is ‘just a label’ for difficult children or caused by poor parenting. This is definitely not the case, and we hope that this work will contribute to a better understanding of the disorder.”

Dr. Martine Hoogman

Dr. Jonathan Posner, associate professor of psychiatry at Columbia University in New York, was not involved in the study. In a linked comment article, he points out that the uniquely large size of the study means that it is “well powered to detect small effect sizes,” which is important when investigating ADHD because of its varied biological and clinical nature.

He notes that the study makes an important contribution by “providing robust evidence to support the notion of ADHD as a brain disorder with substantial effects on the volumes of subcortical nuclei.” He also calls for further studies to track brain differences in the development of ADHD, and suggests that there should also be an investigation of any medication effects.

Use a little mussel if your kids are out of control, new research suggests.

A unique group of fatty acids extracted from the New Zealand green-lipped mussel can help with ADHD, hyperactivity and learning problems, researchers from Swinburne University say.

Children treated with a capsules of the mussel extract over 14 weeks were better behaved at home and had reduced hyperactivity compared to a placebo group, the study published in the February journal of Psychopharmacology found.

Lead researcher Con Stough said the biggest improvements were seen in kids with less severe ADHD.

“What we’d typically see are calmer children that are better able to focus,” Professor Stough said in a statement.

“Which may help them to perform simple daily tasks such as unpacking their school bag, sitting at the table for dinner and reading a book.”

The placebo-controlled study involved 144 children aged six to 14 years.

Prescriptions for medication to treat Attention Deficit Hyperactivity Disorder have increased in North East Lincolnshire.

Doctors in the area wrote 983 prescriptions, or 6.2 for every 1,000 people, for ADHD from July to September 2016, an increase of 3 per cent compared to the number of prescriptions in the same quarter 2015, when there were 954.

The situation was better in North Lincolnshire, where the number of prescriptions fell by 11.6 per cent from 747 to 660.

Overall, the number of prescriptions for ADHD in England increased by 7 per cent from July-September 2015 to July-September 2016 and, in the third quarter of 2016, the NHS spent more than 11million treating the disorder.

ADHD, or Attention Deficit Hyperactivity Disorder, is a neurodevelopmental disorder that causes, especially in children, loss of attention and difficulty controlling their behaviour. People suffering from ADHD also have excessive amounts of energy they struggle to know what to do with.

In children, symptoms are usually diagnosed before the age of six.According to the NHS, the use of ADHD medication for under-16s in the UK is far lower than in many other developed nations – 0.4 per cent, compared with Australia’s 1.9 per cent or the US’ 4.4 per cent.Swale, Kent, registered the highest number of prescriptions per person. Doctors wrote 29.4 prescriptions for every 1,000 people.

The American Academy of Pediatrics and Britain’s Child Poverty Action Group, among various groups and scientific studies, long have documented the higher risk of illness, chronic disease and disability among impoverished children, along with lower birth weights and an average life expectancy nearly a decade shorter than children from affluent families.

Now add asthma and attention deficit/hyperactivity disorder to the long list of physical and mental maladies, along with attendant conditions known as “comorbidities.”

These are the key findings of a Children’s Hospital of Pittsburgh of UPMC study published Monday in Pediatrics.

As it turns out, asthma has risen by 18 percent, ADHD by 44 percent and autism spectrum disorders by 400 percent from 2003 through 2011-12 for all children, with debate about whether they reflect more actual cases or better health care and diagnoses.

But the rise in lifetime prevalence of asthma “was most prominent among poor children,” the study found, with a 26 percent higher rate compared with affluent children, and a 58 percent higher rate among uninsured children.

For ADHD, the increase in lifetime prevalence for children living at or under the federal poverty line was 43 percent higher than those in the highest income bracket. The National Institute of Mental Health describes ADHD as “a brain disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.”

On the other hand, cases of autism spectrum disorders, while rising among children of all income levels, showed a higher prevalence among the “nonpoor” — families with incomes three to four times the federal poverty level.

In addition, poverty put a child with asthma or ADHD at two times the odds of having comorbid conditions when compared with their counterparts in wealthy households, the study found.

Impoverished children with asthma also had elevated rates of learning disabilities, ADHD, and speech and language impairments. Those with ADHD on average had at least two other conditions, with learning disabilities, behavioral or conduct problems and depression or anxiety being the most common.

A clinical trial of book reading to help kindergarten children with Specific Language Impairment learn words has determined the number of times a child with SLI needs to hear a word to learn it: that would be 36 times or exposures compared to 12 times for typically developing children.

This is the first piece of evidence that could lead to the development of an effective treatment for children with SLI, something that Holly Storkel, who directed the trial, says is a critical need.

SLI is a subtle and often undiagnosed language impairment even though it is as common as ADHD—affecting about seven percent of children.

“Children with SLI have difficulty learning new words which puts them at risk for later reading problems and academic failure,” said Storkel, professor and chair of the University of Kansas’ highly ranked Speech-Language-Hearing: Sciences and Disorders department

The trial was a version of interactive book reading, a research-based strategy in which an adult discusses vocabulary words in a storybook with children before, during and after reading the book by describing or defining the word and showing other ways to use it. Although the average child learned only five words over the course of the trial, others learned as many as 12 to 14 words.

The trial used an escalation design adapted from non-toxic drug trials in which 27 kindergarten children with SLI were randomized to one of four intensities of interactive book reading: 12, 24, 36 and 48. After 36 exposures, there was no further improvement in word learning.

In the next study of the trial, funded by the National Institute on Deafness and Other Communication Disorders, Storkel is adjusting the treatment for children with SLI to increase the number of words learned. The aim is to determine if is it better for a child to hear a word many times in one reading and practice the book on fewer occasions; or to hear the word fewer times in one reading but practice the book on many different occasions.

One of the promising aspects of developing a treatment based on book reading is that it could be administered by parents and teachers with minimal training, said Storkel.

“For now, parents of children with SLI should realize that their children need to practice a new word often to be able to learn and remember it,” said Storkel. “When you notice that there is a word your child doesn’t know, try to find ways to work that word into everyday activities, conversations and book reading, and realize that this will need to be done over many weeks.”

Speech-language pathologists who want to start using the approach can freely access the study treatment materials in the KU ScholarWorks digital repository.

It’s estimated one in 10 children in the U.S. have been diagnosed with Attention-Deficit/Hyperactivity Disorder or ADHD, and the numbers continue to rise. NY1’s Erin Billups takes a look at one possible cause of the condition in this report.

ADHD is the most common neurobehavioral disorder among American children.

“It is characterized by a pattern of behavior. The challenge with diagnosing it sometimes though is that there’s overlap between some of the symptoms of ADHD and symptoms of trauma,” explains Dr. Nicole Brown, a pediatrician at Children’s Hospital at Montefiore.

Analyzing parent-reported data from a national survey of 76,000 children, Brown found that kids who experience trauma are more likely to have an ADHD diagnosis. Trauma can be exposure to violence, a family member with a mental illness or even poverty.

“We found really that the number of adversities a child is exposed to is a really strong predictor,” says Brown.

In the study, published in Academic Pediatrics, an ADHD diagnosis was two and a half times more likely among children dealing with at least three traumatic experiences.

And a child with at least four adversities were three times more likely to have an ADHD diagnosis than a child without trauma.

Experts say these adversities can trigger higher heart rates and the release of hormones like adrenaline, creating a condition called toxic stress.

“Toxic stress disrupts the brain architecture and it can lead to many of the behavioral symptoms that you see in a child with ADHD, impulsivity, difficulty staying organized, difficulty with attention,” says Brown.

Brown says more research is needed to conclusively prove a link between ADHD and trauma, work that she will be doing with families in the Bronx.

In the meantime, she’s urging pediatricians to keep the association in mind when screening young patients.

“There are very effective trauma-focused therapies, there are parenting supports that may actually end up helping the child if they’re able to get both treatment for their ADHD and treatment for any underlining trauma,” says Brown.